The voluntary sector was very important in the early development of the Norwegian welfare state. It was decisive for large-scale tasks of welfare provision. We can now observe a radical change in the relationship between the state and the voluntary sector, at the same time as the market sector has gained an important role in the new quasi-markets within health and social services. This chapter emphasizes the implications of this profound change within health and social services. The authors ask why the institution-based voluntary sector, institutionally and ideologically, has ended up so weak and how it could be that market solutions so rapidly gained entry to such an extent, and in areas where this would have been unthinkable not long ago. A core question they try to answer concerns the connection between the entry of market actors and the weakness of the institution-based voluntary sector’s service role.